AML classification in the year 2023: How to avoid a Babylonian confusion of languages
In parallel to the 5th edition of the World Health Organization Classification of Haematolymphoid Tumours (WHO 2022), an alternative International Consensus Classification (ICC) has been proposed. To evaluate the impact of the new classifications on AML diagnoses and ELN-based risk classification, w...
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| Veröffentlicht in: | Leukemia 2023-07, Vol.37 (7), p.1413-1420 |
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| creator | Huber, Sandra Baer, Constance Hutter, Stephan Dicker, Frank Meggendorfer, Manja Pohlkamp, Christian Kern, Wolfgang Haferlach, Torsten Haferlach, Claudia Hoermann, Gregor |
| description | In parallel to the 5th edition of the World Health Organization Classification of Haematolymphoid Tumours (WHO 2022), an alternative International Consensus Classification (ICC) has been proposed. To evaluate the impact of the new classifications on AML diagnoses and ELN-based risk classification, we analyzed 717 MDS and 734 AML non-therapy-related patients diagnosed according to the revised 4th WHO edition (WHO 2017) by whole genome and transcriptome sequencing. In both new classifications, the purely morphologically defined AML entities decreased from 13% to 5%. Myelodysplasia-related (MR) AML increased from 22% to 28% (WHO 2022) and 26% (ICC). Other genetically-defined AML remained the largest group, and the abandoned AML-
RUNX1
was mainly reclassified as AML-MR (WHO 2022: 77%; ICC: 96%). Different inclusion criteria of AML-
CEBPA
and AML-MR (
i.a
. exclusion of
TP53
mutated cases according to ICC) were associated with differences in overall survival. In conclusion, both classifications focus on more genetics-based definitions with similar basic concepts and a large degree of agreement. The remaining non-comparability (e.g.,
TP53
mutated AML) needs additional studies to definitely answer open questions on disease categorization in an unbiased way. |
| doi_str_mv | 10.1038/s41375-023-01909-w |
| format | Article |
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RUNX1
was mainly reclassified as AML-MR (WHO 2022: 77%; ICC: 96%). Different inclusion criteria of AML-
CEBPA
and AML-MR (
i.a
. exclusion of
TP53
mutated cases according to ICC) were associated with differences in overall survival. In conclusion, both classifications focus on more genetics-based definitions with similar basic concepts and a large degree of agreement. The remaining non-comparability (e.g.,
TP53
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RUNX1
was mainly reclassified as AML-MR (WHO 2022: 77%; ICC: 96%). Different inclusion criteria of AML-
CEBPA
and AML-MR (
i.a
. exclusion of
TP53
mutated cases according to ICC) were associated with differences in overall survival. In conclusion, both classifications focus on more genetics-based definitions with similar basic concepts and a large degree of agreement. The remaining non-comparability (e.g.,
TP53
mutated AML) needs additional studies to definitely answer open questions on disease categorization in an unbiased way.</description><subject>45</subject><subject>45/23</subject><subject>631/67/1990/283/1897</subject><subject>692/699/1541/1990/283/1897</subject><subject>Cancer Research</subject><subject>Classification</subject><subject>Critical Care Medicine</subject><subject>Gene sequencing</subject><subject>Genetics</subject><subject>Genomes</subject><subject>Hematology</subject><subject>Humans</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Language</subject><subject>Leukemia, Myeloid, Acute - pathology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mutation</subject><subject>Myelodysplastic syndrome</subject><subject>Myelodysplastic Syndromes - diagnosis</subject><subject>Myelodysplastic Syndromes - genetics</subject><subject>Nucleophosmin</subject><subject>Oncology</subject><subject>p53 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languages</atitle><jtitle>Leukemia</jtitle><stitle>Leukemia</stitle><addtitle>Leukemia</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>37</volume><issue>7</issue><spage>1413</spage><epage>1420</epage><pages>1413-1420</pages><issn>0887-6924</issn><issn>1476-5551</issn><eissn>1476-5551</eissn><abstract>In parallel to the 5th edition of the World Health Organization Classification of Haematolymphoid Tumours (WHO 2022), an alternative International Consensus Classification (ICC) has been proposed. To evaluate the impact of the new classifications on AML diagnoses and ELN-based risk classification, we analyzed 717 MDS and 734 AML non-therapy-related patients diagnosed according to the revised 4th WHO edition (WHO 2017) by whole genome and transcriptome sequencing. In both new classifications, the purely morphologically defined AML entities decreased from 13% to 5%. Myelodysplasia-related (MR) AML increased from 22% to 28% (WHO 2022) and 26% (ICC). Other genetically-defined AML remained the largest group, and the abandoned AML-
RUNX1
was mainly reclassified as AML-MR (WHO 2022: 77%; ICC: 96%). Different inclusion criteria of AML-
CEBPA
and AML-MR (
i.a
. exclusion of
TP53
mutated cases according to ICC) were associated with differences in overall survival. In conclusion, both classifications focus on more genetics-based definitions with similar basic concepts and a large degree of agreement. The remaining non-comparability (e.g.,
TP53
mutated AML) needs additional studies to definitely answer open questions on disease categorization in an unbiased way.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>37120689</pmid><doi>10.1038/s41375-023-01909-w</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8571-1551</orcidid><orcidid>https://orcid.org/0000-0002-9038-3265</orcidid><orcidid>https://orcid.org/0000-0002-6333-5049</orcidid><orcidid>https://orcid.org/0000-0002-7374-4380</orcidid><orcidid>https://orcid.org/0000-0002-6452-2874</orcidid><orcidid>https://orcid.org/0000-0003-0196-2837</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Leukemia, 2023-07, Vol.37 (7), p.1413-1420 |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | 45 45/23 631/67/1990/283/1897 692/699/1541/1990/283/1897 Cancer Research Classification Critical Care Medicine Gene sequencing Genetics Genomes Hematology Humans Intensive Internal Medicine Language Leukemia, Myeloid, Acute - pathology Medicine Medicine & Public Health Mutation Myelodysplastic syndrome Myelodysplastic Syndromes - diagnosis Myelodysplastic Syndromes - genetics Nucleophosmin Oncology p53 Protein Risk analysis Runx1 protein Transcriptomes Tumors World Health Organization |
| title | AML classification in the year 2023: How to avoid a Babylonian confusion of languages |
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